Ophthalmology billing services
Ophthalmology Billing and Revenue Cycle Management Services
LMC manages the full ophthalmology revenue cycle, from the first insurance inquiry through final payment, patient responsibility, reporting, and resolution. One accountable team, connected from start to finish.
Full-service RCM
Every step of the ophthalmology revenue cycle.
Eligibility and Benefits Verification
We review coverage, plan requirements, referrals, deductibles, copays, coinsurance, and the ophthalmology-specific benefit details that decide whether a visit is billed to medical or routine vision.
Charge Entry
Professional, surgical, injectable, diagnostic, and ASC-related charges are entered accurately, with the drug units, laterality, and provider details ophthalmology claims depend on.
Claim Scrubbing and Submission
Coding, modifiers, ordering and referring providers, and payer-specific requirements are reviewed before submission, so problems are caught before a payer finds them.
Payment Posting and Reconciliation
ERA and EOB activity is posted and reconciled, including contractual adjustments, patient responsibility, denials, and payer takebacks.
Denial Management and Appeals
We research the cause, correct the underlying issue, prepare the appeal, and track the claim through resolution rather than stopping at resubmission.
Insurance A/R Follow-Up
Actionable balances are prioritized, payer delays are evaluated and escalated, and every follow-up is documented. See A/R recovery.
Patient Statements and Financial Communication
Accurate balance transfer, statement workflows, and patient responsibility review, supported by staff training on financial conversations.
Reporting and Guidance
Revenue cycle data translated into clear findings, operational concerns, and recommended next actions your leadership can act on.
Specialties
Ophthalmology subspecialty billing.
Cataract and Premium IOL
Covered cataract surgery and noncovered refractive upgrades, separated correctly.
Learn MoreRetina and Injectables
Buy-and-bill drugs, NDC reporting, JW and JZ modifiers, and prior authorizations.
Learn MoreOphthalmology ASCs
Professional and facility claims coordinated across surgeon and center.
Learn MoreA/R Recovery
A structured method for aging insurance balances: analyze, prioritize, recover, prevent.
Learn MoreWe also support glaucoma procedures, oculoplastics, diagnostic testing, medical and routine vision coordination, secondary and crossover claims, and corrected claims and payer reconsiderations.
Included in every engagement
What full-service should mean.
Ongoing Staff Training
Front desk and clinical staff training is part of every contract, so the problems that start upstream stop starting.
U.S.-Based Professionals
Every account stays connected to experienced revenue cycle professionals who know the practice and its payers.
Getting started
How an engagement begins.
Revenue Review
We learn your practice, payer mix, system, and current performance.
Findings and Plan
You see what is working, what is not, and how the transition would run.
Ongoing Management
LMC takes responsibility for the cycle, with regular reporting and guidance.
FAQ
Questions about our services.
Do you offer partial services, or only full-service billing?
LMC is built around full-service revenue cycle management because isolated tasks hide the root cause of problems. Ask about project-based A/R recovery during your revenue review.
Do you handle both medical and routine vision claims?
Yes. Coordinating medical and routine vision benefits is one of the most common sources of ophthalmology billing errors, and it is part of our standard work.
Will we have to change our practice management system?
No. LMC works within the system you already use and does not require a software change as a condition of service.